So, now that this
journey has reached its first major milestone, I’m going to stop worrying,
relax and write a post. I can’t get my head around the fact that I have matched
and come 07-17, I will be PGY-1 resident at some awesome program in the United
States. All that worry, indecision, regret, hopelessness, guilt, the
awesomeness of the interviews has reached the end.
The worst part about
applying for residency in the US is the long long journey. While my batch mates
here, took one entrance exam, got ranked according to their marks and then
participated in counselling rounds to get the specialty they wanted, I had to
wait a year before I was even eligible to apply. Where they just took a single
exam, I had to take 3 nine-hour exams, one of them in the United States. While
they studied in the library of our medical school, I was applying for electives
and experiencing the brilliance that the American Medical system is. Its been a
whirlpool of all sorts of emotions. Worth a movie really. Or at least a book –
The Hitch Hiker’s Guide to the Match J
I have questioned
myself at numerous times throughout these past two years. The first time: when
I got my first rejection for a clinical elective. I probably disguise a bit my
own low self-confidence in the form humility, but I was asking myself why I
even thought that any university would love to have me there. Then came a great
moment, when Yale sent me an acceptance into their Infectious Diseases clerkship.
I could see my plan forming a little bit, moving a couple of steps.
And then it stopped
again. No more acceptance emails. I needed at least one more elective to get
the minimum required US Clinical Experience (USCE). And nothing. One fine day,
I get an email from Harvard saying I was accepted into their elective. The
elective that clashed with my Yale dates. I had to reject it. I remember saying
to my mother on the day I left for the US, “if I get one more elective, it’s a sign
from God that this is the path I’m meant to take.” Harvard decided to smile
upon me yet again and offered me a second elective, this one at none other than
Mass Gen Hospital. Yes, during those two months, I felt pretty great about
myself.
The USMLE exams are a
whole different ballgame. Studying for them was tough, yes. But, sitting
through an 8 hours exam for the first time ever, is enough to knock you flat. I
knew I didn’t do fantastically well on it. When I got my score, I knew it was
good. But that’s just what it was. Good. Not the best, not awesome, not the see-the-score-read-the-eras-profile
kind of score. When I took the Step 2 CS, I was sure I had given it everything
I had. I wasn’t sure whether it was enough though. I think everyone needs to
take this exam once in their lives. It is so real and so strange. I was pretty
sure I was going to fail it, actually. Because I thought my cases were weird.
Now I know everyone says the same thing after coming out of this exam. I was
most petrified of that result. The moment I saw that ‘PASS’ written on my score
report, I started crying. That was a first. Crying because I felt like I’d
gotten some major victory under my belt.
It was after this
result that I went into a sort of manic mode. I decided that applying immediately
would serve me best. I ended up taking the Step 2 CK as late as I possibly
could, but still early enough that I’d be eligible to apply in Match 2015. That
exam was a disaster. When I came out of the Prometric Centre, I knew I would be
questioning what went wrong in my head, when I decided to take this whole USMLE
plan through. Even now, I feel a mix of relief and disappointment when I think
of my CK score.
My next questioning
moment was when I applied to fewer programs than everyone else in the same
boat. When I was doing my research, it made sense to me, to apply to programs
that could see me as a potential candidate. Why should I apply to a program
that said they wanted 3 months USCE when I had only 2? Why would I apply to a
program that was situated in a place I knew I’d never stay in? So, yes, it all
made sense at that time. After MyEras opened and people started getting
interview calls from everywhere, I questioned all of that rationality. What
harm would it have done to apply to a few more?? When I got my first interview
call, I was delighted. Again, this plan appeared to move further towards its
destination. Then came the stop. Nothing more for almost 1.5 months. I started
thinking back-up plans, avoiding my own thoughts to avoid my own questions and
wondering why at 24, I couldn’t even believe that I was 24 years old.
Going to the
interviews was nerve-wracking to say the least. I had half a mind to not get
into that US-bound aircraft. I was more than happy to run away and figure out
something else for myself. I had to keep playing all those morals I had learnt
from Harry Potter and Lord of the Rings in my head to give me courage to face
this head on. It did not matter that I actually had fun at the interviews, met
new people, made conversations with students from all over the world and felt
great about my chances. When I came back, I had another disaster heading
towards me – my ECFMG certification.
Once you get your
degree, you send ECFMG (the Dean’s Office for International Medical Graduates)
a copy of that degree. They look through it and then send a form to your
medical school, asking them to verify stuff from their side. The school is
supposed to do this and then resend the form to ECFMG who finally verify your medical
credentials and issue the ECFMG certificate. As has been the pattern in my
USMLE prep, this took ages. I had to get certified before the last date of
Rank-Listing. Phone calls to ECFMG and trips to my medical school did not seem
to fasten the process. That was the first time, I decided to bury my head in
the sand and just let go of this dream. It was sort of my fault that this
process did not happen earlier, right? If I’d planned things properly from the
very first day of my internship, I’d have spent a happy February with nothing
to worry about. Instead, I spent sleepless nights and frowning days, avoided talking
about the future even when my parents pushed for it, dove into fiction as if it
were my last tank of oxygen. When that certificate was issued 6 days before the
last day of Rank-Listing, I felt like a phoenix rising from the ashes. I was
reborn. At least now, if I did not match, it would be because I wasn’t good
enough. Not because I didn’t have the documents in place.
You’d think that
believing something like that, rejection because you’re not good enough, would
be a blow to your mental health. But, I’d rather have a failure that I could
blame myself for. Maybe this is a little childish, but it gives me a sense of
clarity to think like that.
Now, lets come to
Match Week. Frankly, I did not believe that it was really happening, All that I’ve
done, the electives, the exams, the interviews still feel like a dream. I’ve
never thought that I could be brave enough to do it all, so looking back, it
doesn’t seem real. I couldn’t believe that I would match because of this whole
dream thing. I mean, how could it really happen right? How could a dream just
become reality?
I had a sleepless
Sunday night. Having avoided the thoughts for the whole day by keeping my mind
busy, I couldn’t bring my mind to calm down during the night. I was jittery. I
had to attend a new OPD, shadow a new consultant on Monday. That always makes
me a little nervous. Add on these nerves, and I was pretty gone. I jumped at
the opportunity to convert this OPD day into a research day instead. Then I
plugged on my head phones and listened to music and buried myself in the
records section of the hospital. When evening came though, there was nothing
else left. No defence mechanisms that could suppress the thoughts of not
matching and having to deal with SOAP (the post-Match Supplemental Offer and
Acceptance Program). When you are in a time zone that’s 9 hours ahead of the
US, it sucks to participate in the SOAP. You can’t be physically present for
any interviews that might come your way. You have be up all night to make sure
you at least get a skype or telephone interview. And you have just 2 hours to
accept an offer. This goes on for 3 whole days. If you are at an institute like
mine, where you are busy all day from 7 am in the morning, this is a nightmare.
It goes without saying
that I did not want to have to go through SOAP. But, I couldn’t stop stressing,
couldn’t stop thinking. And then fate decided to intervene. The wifi connection
at my house decided to give way. Completely. And it refused to right itself.
Suddenly my thought were torn from having to participate in the SOAP to whether
or not I would be able to even see my Match status in the first place. I had to
make the decision to come back to my hostel room and rely on the so-s- wifi
here. That relaxed me a little. For a while I had to think about arranging
transport to the hostel, my food requirements, etc.
Of course, the moment I
got to my room and set things up, the jitters came back. This time, good old
site-load helped me through. I couldn’t open the NRMP pages fast enough, there
was no message anywhere saying that I had/hadn’t matched. That made me believe
I hadn’t matched of course. So I went onto the SOAP link. And it said: You’re
not Eligible for SOAP.
There is only one
reason why you go from being SOAP Eligible on the Friday before Match Week to
being SOAP Ineligible on the Monday of Match Week. Several agonising minutes
later, I saw the message that calmed me to numbness, such a strange numbness I
think I floated out of my body and saw myself sleeping peacefully for the next
three nights in that hostel room bed.
CONGRATULATIONS! YOU
HAVE MATCHED!
I think in the line of
major achievements, this by far trumps everything. I don’t know where I’m going
to my residency. I know that the places I interviewed at, I loved. So anything
I get will be awesome and make me happy. I can’t ask for any more. What I can
do now, is reflect on how this journey helped me grow up a little. I know if it
hadn’t been for this decision, I would never have ventured out of my own city.
Instead, I flew all over the US twice in the past year and am now spending a
month in Hyderabad by myself. I would never have been capable of believing that
I can meet new people and make new friends, and not feel out of place. I would
never have known that I do have the mindset and belief to see myself through
anything.
I never believed that
I’d ever take the path less trodden. Robert Frost’s “The Road Not Taken” had
struck a big chord back in school. But I never thought I’d embark upon something
like that. You always hear stuff like, challenge yourself, get out of your
comfort zone, the success you achieve by going straight ahead is never sweet
enough. But do you actually do it? I’d like to believe this me doing that. Yes,
I always wanted to get my further education in the US. But I saw myself going
through SAT/GRE and getting into some academic program there. When I got into
medical school, those dreams were buried by the wealth of knowledge there was,
to accumulate.
I never liked Frodo
Baggins in LOTR. I felt he was too dark, too depressing in his journey to
destroy that Ring. I understand him now. Yes, my life was never in danger, I
did not have to worry about the basic necessities of life in this journey, but
it was a journey that questioned me, a journey that put obstacles in my path, a
journey that challenged but did give some respites.
I have always loved
Harry Potter for facing challenges head-on and getting through it all. He was
the first to say he always had help, but what use is the help if you don’t have
the courage to stand in the battlefield? I had to dig deep into my own stores
of courage, gather every dialogue from both these series that shaped my
childhood. I might still not feel very worthy of any new achievement that may
come my way. But, I know that if I could snag a residency in the US, be the
first from my entire family to do it in medicine and feel proud of myself right
now, I will be able to do anything I want in the future.
My family and God,
thank you so much for supporting me through this and allowing me this
opportunity. To my Idol, the late Kalpana Chawla. You talked about a journey
from a small village in India to the stars. You have always been my
inspiration, from the time I had a photo of the whole Columbia Team stuck to my
study table, to every interview where I talked about you and your incredible
journey. I hope that this leap I am taking from my own small city to the Land
of the Free will help me build my own new dreams and reach for my own stars.
I matched! Game, Set,
Match J
